What are the alternatives to targeted therapy?

Targeted medicines work only when a tumour has a suitable molecular feature and the medicine is likely to reach its cells. Testing of tumour tissue or blood can help establish this. If no relevant target is found, the cancer has stopped responding, or side effects are difficult to manage, the team may consider another approach. Chemotherapy acts on rapidly dividing cells; immunotherapy helps the immune system recognise cancer in selected settings; radiotherapy focuses treatment on a region; surgery removes disease that can be safely removed. The most suitable plan differs between lung cancer, melanoma, kidney cancer, liver cancer, leukaemia and gastrointestinal stromal tumour.

Ask whether biomarker testing is complete and whether a second sample is needed. Discuss the treatment goal, how it is given, likely monitoring, effects on daily life and what happens if the cancer changes. Keep a current list of medicines and tell the oncology team about previous treatments, allergies and other health conditions. A multidisciplinary review can help match the plan to the cancer type and its extent.

Contact the oncology team promptly for fever, breathing difficulty, chest pain, severe diarrhoea, persistent vomiting, new confusion, unusual bleeding, or rapidly worsening pain during treatment. Seek emergency help for severe breathlessness, collapse, or signs of a serious allergic reaction such as facial swelling or trouble breathing.

What did my biomarker tests show? What is the goal of the proposed alternative? Which side effects need immediate attention? How will scans or blood tests show whether it is working?